Karl Rove: The GOP's Self-Defeating 'Defunding' Strategy

It will only strengthen the president while alienating independents.

In 2010, Republicans took the House of Representatives by gaining 63 seats. They also picked up six U.S. senators and 675 state legislators, giving them control of more legislative chambers than any time since 1928. The GOP also won 25 of 40 gubernatorial races in 2009 and 2010.

These epic gains happened primarily because independents voted Republican. In 2010, 56% of independents voted for GOP congressional candidates, up from 43% in 2008 and 39% in 2006.

Today, independents look more like Republicans than Democrats, especially when it comes to health care. In a new Crossroads GPS health-care policy survey conducted in 10 states likely to have competitive Senate races and in House districts that lean Republican or are swing seats, 60% of independents oppose President Obama's Affordable Care Act. If this holds through 2014, then Republicans should receive another big boost in the midterms.

There is, however, one issue on which independents disagree with Republicans: using the threat of a government shutdown to defund ObamaCare. By 58% to 30% in the GPS poll, they oppose defunding ObamaCare if that risks even a temporary shutdown.

ENLARGE

A billboard on in New York advertising the defunding of Obamacare.
Reuters

This may be because it is (understandably) hard to see the endgame of the defund strategy. House Republicans could pass a bill that funds the government while killing all ObamaCare spending. But the Democratic Senate could just amend the measure to restore funding and send it back to the House. What then? Even the defund strategy's authors say they don't want a government shutdown. But their approach means we'll get one.

After all, avoiding a shutdown would require, first, at least five Senate Democrats voting to defund ObamaCare. But not a single Senate Democrat says he'll do that, and there is no prospect of winning one over.

Second, assuming enough Senate Democrats materialize to defund ObamaCare, the measure faces a presidential veto. Republicans would need 54 House Democrats and 21 Senate Democrats to vote to override the president's veto. No sentient being believes that will happen.

So what would the public reaction be to a shutdown? Some observers point to the 1995 shutdown, saying the GOP didn't suffer much in the 1996 election. They are partially correct: Republicans did pick up two Senate seats in 1996. But the GOP also lost three House seats, seven of the 11 gubernatorial races that year, a net of 53 state legislative seats and the White House.

A shutdown now would have much worse fallout than the one in 1995. Back then, seven of the government's 13 appropriations bills had been signed into law, including the two that funded the military. So most of the government was untouched by the shutdown. Many of the unfunded agencies kept operating at a reduced level for the shutdown's three weeks by using funds from past fiscal years.

But this time, no appropriations bills have been signed into law, so no discretionary spending is in place for any part of the federal government. Washington won't be able to pay military families or any other federal employee. While conscientious FBI and Border Patrol agents, prison guards, air-traffic controllers and other federal employees may keep showing up for work, they won't get paychecks, just IOUs.

The only agencies allowed to operate with unsalaried employees will be those that meet one or more of the following legal tests: They must be responding to "imminent" emergencies involving the safety of human life or the protection of property, be funded by mandatory spending (such as Social Security), have funds from prior fiscal years that have already been obligated, or rely on the constitutional power of the president. Figuring out which agencies meet these tests will be tough, but much of the federal government will lack legal authority to function.

But won't voters be swayed by the arguments for defunding? The GPS poll tested the key arguments put forward by advocates of defunding and Mr. Obama's response. Independents went with Mr. Obama's counterpunch 57% to 35%. Voters in Senate battleground states sided with him 59% to 33%. In lean-Republican congressional districts and in swing congressional districts, Mr. Obama won by 56% to 39% and 58% to 33%, respectively. On the other hand, independents support by 51% to 42% delaying ObamaCare's mandate that individuals buy coverage or pay a fine.

The desire to strike at ObamaCare is praiseworthy. But any strategy to repeal, delay or replace the law must have a credible chance of succeeding or affecting broad public opinion positively.

The defunding strategy doesn't. Going down that road would strengthen the president while alienating independents. It is an ill-conceived tactic, and Republicans should reject it.

Mr. Rove, a former deputy chief of staff to President George W. Bush, helped organize the political action committee American Crossroads.

With apologies to the Kingston Trio and to Thomas Paine, these are the times that try men's souls.

In the course of our nation's history, the American people have rallied bravely, whenever the Rights of Man have been threatened.

Today a new crisis has arisen -- the launch of OhBummerCare. And where are the Senate Republicans?

They are dithering. They are candles in the wind. They flicker in one direction, and then in another --- and there are less kind observations now afoot, across this mighty land.

The Republicans cannot find their bums, with both hands and a flashlight.

They keep their cojones locked in a bank vault --- although if they were valuable to Republicans, you'd think they'd take them out for a spin, once in awhile, now wouldn't you?

When asked how best to destroy the Soviet communist dictatorship, novelist and Nobel Prize winner Aleksandr Isayevich Solzhenitsyn replied, "Don't lie." The corollary of that injunction is, "Tell the truth."

This is a gangster government, of Barak Hushpuppy OhBummer, and the OhBummer Wrecking Crew.

This is a dictatorship. If Republicans fail to smite it a mighty blow, then they are cowardly, worthless trash.

Did I leave anything out? For what do we need them, if they will not fight?

Fund everything except OhBummerCare and let the Democrats shut down the government.

It does not matter that the fascist Democrat-captured media will lie and blame the Republicans.

The Democrats always lie. Lies are the heart and soul and the sword and shield of the Democrat party.

To the Senate Republican I say this. "Be a man. Drive a wooden stake through the heart of OhBummerCare.

"The vast majority of the American people do not want OhBummerCare --- so be a glad warrior --- and destroy it."

About that "It's the law of the land" JAZZ and the fact that Justice Roberts LIED and called a penalty a tax and the tax didn't originate in the House, as constitutionally required. This is a gangster government and this is a dictatorship. Whether the Republicans wake up and remember that they are men and do their best to destroy this ugly mess, or whether they cower before the fascist Democrat-captured media, and supinely go along with the Democrat thugs, the American people are the third force --- and I ask them now to sabotage OhBummerCare at every turn and in every way possible, large and small, to overthrow it by any means at hand, whatever it takes, to bring it to its knees and then to behead it.

Karl Rove is a hack, and I wish the WSJ would peddle him to the Salvation Army. Conservatives are tired of negative soothsayers like him and will not follow him. Period. So the republican party's fortunes either rest with Rockefeller republicans or some, as yet, unidentified demographic.

Much to liberals' consternation, the Tea Party is going to be around for a long time. And someone should tell Karl the sky isn't falling; he is!

Rove is not a "hack" but he, in my opinion, is too caught up in the HUGE industry and tactics thereof that comprise national politics in the US today. Mr. Rove is all about the battle but neither he nor Axelrod want the war to end. It is too lucrative and invigorating. Similar to WWI in which neither side could gain a significant advantage but both kept expending resources (and people).

As to Obamacare, the vindictive part of me wants the unions and the other twits who voted the President in for a second term (slow learners all) to own Obamacare and live with it. Problem is that we'll likely end up with single payer for all the plebiscite while the O fans who post here will write bigger checks for their coverage and blame anyone but the guy (or gal) in the mirror.

Our foreign policy is indecipherable. We are liked by few to none, respected or feared (which is an adequate substitute in most cases) by fewer now than five years ago and our "leadership" doesn't know what they want to be when they grow up.

When I was in high school (shortly after the invention of movable type) we were discussing the cold war.One of us asked our instructor (a nun) what would happen to civilization if we lost. Her reply was that there will probably always be a center of civilization, but not necessarily in the US. We get to keep this thing we have if we earn it every day and year. We, as a country, are not doing that now.We have had it too easy, too long. The country has gotten fat and stupid. Too many vote for circuses and bread, to few for work. This will eventually get fixed but I doubt we will enjoy the cure.

"These epic gains happened primarily because independents voted Republican." === Just what I would expect from an Establishment Republican ... no mention anywhere in the article that maybe the Tea Party had something to do with the "epic gains". As long as Republicans are elected, Rove is happy ... regardless of how they vote when in office. newsandopinions dot net

So, it would take five Dem Senators to agree with House defunding Obamacare? Well, it would take 17 GOP House members to agree with the Senate to fully fund Obamacare. Five < 17.

For GOP bigwigs to accede to framing this standoff as a “GOP ordered shutdown” is pre-emptive surrender. Shame on Rove & Co.

If we had listened to them originally and not sent over the bill fully funding everything but Obamacare, we would have zero leverage at this point. If they would shut up and close ranks, we may be able to get larger chunks of this monstrosity delayed.

Never could figure out why the Republicans ran Mitt Romney. Correct or not, he was viewed as father of Romney care, the grandfather of Obamacare. With most Americans blaming big banks (not government housing policy) for the financial meltdown, he was a lifelong businessman. They ran a gentleman against a Chicago street fighter. But he appeared to be the best and only choice. Republicans are running a deficit on leadership. Instead of wasting time on a government shutdown, the Republicans should be looking for a charismatic statesman to run against Hilary. Is there one? Further, why not let Obamacare run its course? Once Americans experience the ensuing chaos, the Republicans alone won't have to vote to defund it. As people suffer the consequences of the bill - like shortened work weeks - the Democrats will join them in watering it down or getting rid of it, when enough of them lose their seats. Let's see if Obama can blame the Republicans for the chaos.

Karl Rove at once says he wants to defeat Obamacare, yet we may not oppose it. We cannot fight to defund it because the squishy middle, whose allegiance blows hot and cold according to what the press tells them to think, is SUPPOSEDLY opposed to shutting down the government.

We want Obuttplugcare shut down, if the Democrats will shut down the government to save it...let 'em.I will remind those who are leaning toward Rove's strategic planning, just remember the candidates Rove supported last year with his PAC mostly lost. Rove isn't within his depth here, about to drown is my opinion.

Rove, you're wrong again. The Republicans won the 2010 elections overwhelmingly due to the efforts of the Tea Party and public disgust with Obamacare. They didn't win because of your precious little "independents", you weasel. If it weren't for the Tea Party and like minded Patriots, your buddy and fellow airhead, Nancy, would still be Speaker. And you have the Chutzpah not to even mention the Tea Party in your RINO op-ed. When are you going to retire already and quit giving bad advice?!

Well, the fight for president is already starting. You have Jeb Bush, the U.S. Establishment’s candidate vs. Ted Cruz, the charismatic Reaganite. I think the smart money knows the Fed (real U.S. President Janet Yellen) will create a bubble-bursting mess, finishing Hillary, so they have to fall back on Jeb, and thus stop Ted at all costs. Rand Paul is too into legalizing illegal drugs. Wrong party for him.

The U.S. Establishment’s main hit man, aka Super RINO Karl Rove, is hoping this fight on ObamaCare will help Jeb Bush and hurt Ted Cruz. It will do neither. It’s a big side show during a slow news period.

What would be helpful from Mr. Rove, who the U.S. Establishment plays up as a statistical genius, is to explain ObamaCare to the American public. Does anyone know what is in it, and how it will work? Two writers from this paper (The WSJ) tried to explain the first part of it, showing taxpayer-provided credits; then some annual deductibles based on bronze, silver, or gold plans; and, I guess they will someday compare the ObamaCare policies against Fortune 500 policies (e.g., annual out-of-pocket amounts (policy user pays first $1,000 or $2,000 or $3,000, then insurer covers 80% or 90% or 100 % of benefits for year); the actual list of benefits; who pays for all benefits---taxpayers?). Will it provide much better benefits and lower annual out-of-pocket in an attempt to try and get the Fortune 500 to dump their employees and retirees into it, and put private insurers out of business? Then ObamaCare will clamp down afterwards (vicious rationing and death panels)? Or will its taxpayer-funded benefits be terrible and out-of-pocket costs outrageous? Who knows?

We have this so-called big fight over something no one seems to know anything about. We can poke fun at knucklehead Nancy Pelosi for her incredibly infamous remark about passing ObamaCare so we can know what is in it; or, knucklehead Harry Reid, who is more concerned about how bad Americans smell rather than anything else. But it appears these two are not the only knuckleheads in DC.

Rove, misses a significant point which is that republicans didn't vote to shut down the government or to not pay the bills. Therefore the survey question he points to does not apply. In fact they voted to pay the bills while not paying for Obamacare. Now the democrats in the Senate have to be petulant and vote to shut-down the government or agree to deal with Obamacare as a separate issue from the rest of the country's bills. The democrats of course don't like that idea because they don't want to be forced this close to the campaign season to go on record as supporting a ACA which the majority of Americans don't want.

Hey Karl - If your "let's all learn from history" approach is so valid, shouldn't we all learn from the fact that you and your ilk helped BRING US Obamacare by losing the House in 2006? And that Republicans continue to lose a huge majority of the elections in which you and your organization involve yourself? Please find some other endeavor.

AND, TO THE EDITORS OF THE WALL STREET JOURNAL: WHY do you continue to be so interested in what this man has to say? Are you still publishing op-eds from Tom Daschle, too?

Karl Rove wants to bring a knife to a gun fight or he just doesn't want to fight at all. Karl, we are in the arena whether we like it or not and retreat is NOT an option. You're like that junior officer who advised General Grant about a plan to retreat. Grant's rejoinder was, "I'd rather hear your plan to advance against the enemy." Your screed indicts you as a cheese eating surrender monkey.

I did study medical economics 40 years ago. Also, I worked in 4 different medical schools over a period of 15 years in 70-80's. Some of my detailed info maybe out of date, but I will proceed: After WWII, the unions for the large mfg corps, recognized that they would gain a great deal more $$ if they negotiated with the govt and the corps for employer paid medical insurance. I grew up in the 50-60's in a family of 6; my father had his own small business and no medical insurance--just life-for him. We got all the medical care we needed, we were vaccinated & rx'd as necessary etc. One of my brothers lost an arm in a boating accident in '57, and Dad took out a 2nd mortgage to pay the 15K for hospital and rehab. It got paid off. Our power was turned off in a Feb only once. In the late 60's I had eye surgery, to keep from losing one. My annual salary was $3800 no med insur. The hospital bill was $195, the surgeon's bill came in at $1,000. When I called the Dr's office they asked if I could pay $10/mo. Oh yes. So I paid $10 each month, and as my salary increased so did my pymnt until finally I paid it off in full 4 years later.Also in the 60's, the econ profs in the NE came to the conclusion that the variable costs of medical care determined for the most part by the medical practitioners, was economically inefficient. Every patient should face exactly the same costs/charges. So lo and behold, medical insurance became the vehicle for payment--Medicaid for the indigent, Medicare and private insurance for everyone else. BUT, Individ private insurance was not affordable for the middle class except with a large deductible. Interestingly, the cost of medical insurance is not tax deductible, the only OP medical expenses that were deductible are those that exceeded 7% of household AGI. I checked the tax code just a few years ago. These sections have never been changed. The govt put a lot of economic pressure on the employers to provide medical insurance for their employees--costs are not subject to FICA taxes, and employees felt the immediate financial benefits as medical costs started rising in the 60's. The mean physician income in the 70's was at the 95%tile, today, it is in the 98%tile.

I consider it very ironic that today the only folks who face the full price for their medical care are those who don't have any medical insurance. Oh yes, a last anectdote: One neurologist I worked with had the best slides of brain cancers you've ever seen. Great teaching tools, great for delineating the 'natural history' of various tumors. I asked him how he acquired them. "I did my neuro fellowship in West Germany, where they have socialized medicine. The patients cannot get into to see a neurologist until the cancer is so far gone, there is no treatment." oh yes, my husband & I now have only a major medical care policy. Our attitude about going to doctors has changed radically.

The Republicans claim that "the American people hate ACA". Problem is, from the comments I've read here, those who have ACTUALLY LOOKED INTO THEIR HEALTH CARE COSTS UNDER ACA have seen their health care costs drop from what they had been paying.

Among the readers of this article, does anyone see their health care costs going up under ACA? Anyone care to share their story?

If conservatives believed in their own principles, that is the marketplace of ideas and faith in the American people, they'd let Obamacare go into effect and fail on its own. But the reason Repubs are so apoplectic is they fear that people will actually like it. They'll like that they can't be denied insurance because of a pre-existing condition. They'll like that they won't have to choose between eating and medication if they're thrown off their own health plan because they get cancer. They like that their kids can stay on their health plan until they're 26. They like free mammograms and the emphasis on preventative care as opposed to fee for service. And they'll like that they'll be subsidized for it if they're low-income. One more thing: the irony is that as corporations start eliminating their own health plans, forcing people onto the health exchanges, we may just get a single-payer system after all. Turns out, Barry is smarter than all of you combined. Makes me so giddy, I want to do a little soft shoe on Jefferson Davis' grave.

I agree with most of what you say, Bill. But I stand by my description of Rove being a hack. My dictionary defines "hack" as "a writer or journalist producing dull, unoriginal work". Rove repeats himself every column and when liberals like Rob Candee agree with him, you know he's fundamentally flawed - at least from a conservative point of view..

Actually, the stupid (and now crazy) party has been rather adept at losing 5 of the last 6 popular votes in the national election. It even lost the popular vote in the House by 1,400,000 votes. Crazy BS is no improvement on stupid BS.

That is exactly what I thought when I read Rove's essay. Rove has a vested interest in maintaining the Republican establishment. The Republican establishment has a strategy of being "Democrat Lite" and hoping that will win an election or two while keeping the establishment "active and involved" in government.

That worked once when Rove convinced us "Compassionate Conservative" was different than "Democrat Lite", but they turned out to be identical. Karl Rove has no principle that motivates him except for his own advancement. It is time to ignore Karl Rove.

That is supposed to be the strategy, but Karl Rove clearly spells out what he next steps are going to be. Already, Sen Cruz is being called out by Conservatives in the House, and the GOP train wreck is going to be delicious to watch.

The President has been successful in making the GOP act and follow through with its radical and incendiary language, and now they are waaay out on that limb, with Harry Reid and Obama each holding chainsaws.

I think you have it just about right. The campaign by the House Republicans, and Senators Cruz and Lee (among others) was never about actually getting ObamaCare defunded, as they all knew that was impossible. Rove just doesn't seem to get that at all, which is surprising for an otherwise intelligent man. The House has voted to repeal ObamaCare some 40 times, then sent the bills to the Senate, where the Senate (Harry Reid) has refused to vote at all every time. This time, however, because it's attached to a continuing resolution, THEY HAVE TO VOTE! This, finally, gets all the Senate Democrats on the record, and prevents them from weaseling out, which is what they love to do. This whole maneuver is about getting Democrats on the record in favor of ObamaCare, and then carrying that message to the people in the 2014 election. I think it's a very sound strategy.

As to what will actually happen, I think it goes like this. The House passes the CR, the Senate then votes to fund ObamaCare (and possibly to restore the sequester, although I doubt it) and sends it back to the House. Then the House either gets all the Democrats to vote for it, and enough "safe seat" Republicans to pass it, and it goes to Obama for signature. There is no government shutdown, but clear lines are drawn to set up the 2014 election. I like it, and hope they do the same thing with the debt ceiling in October.

Sorry Frank, but Karl Rove is right in his analysis and conclusion. I'm no fan of his but the GOP will be the OP after the next election if they continue down the path taken. Only a low turnout in '14 can save them from a significant defeat, perhaps so large that the House will be ruled by our favorite candidate for America's version of Eva Peron. The American public wants affordable healthcare. The current system is not providing that. The media is on the side of ObamaCare and the independent voter sees us as rich, egocentric and antisocial. In their eyes we are the devilI's messenger. Is it better to be out in the wilderness for 40 years and be right or in power and be mostly right. I'll chose the latter. Let's win the election and then play poker with a lame duck.

On your first point, I think this is a key difference between the conservative and liberal mindset. Liberals recognize that governments are not businesses; they cannot tolerate risk, they have overwhelming market setting capacity; and here, at least, they are messy democracies. Conservatives tend to believe that a government should be turned into a business, I think, because of a core belief that every dollar going to the federal treasury is a dollar not going into someone's pocket. Obviously I am in the former camp, and I think the idea that "government doesn't create jobs," is basically just rhetoric.

On your second point, the way we push what should be nationally rationalized priorities down to the state level exacerbates the situation. One of the great achievements of Reagan, if I remember the history, was that "local dollars equals local control" tripe. Sure it does, and since local government can't print dollars, I see the attraction. It also means "local dollars equal poor communities being under educated compared to the nice wealthier communities," which is either a fringe benefit, or a diabolical scheme, depending on one's perspective.

On your third point: All economies are human contrivances, and certainly medicine can't escape that. My view is denying care to 50Million people so the rest of us can have "the best care in the world," is a very unfair human contrivance. That improving the welfare of 50 Million workers in this country isn't seen as a substantial benefit to the economic efficiency of the nation by, of all people, capitalists, seems too suggest ulterior political motives.

In points four and five, I am taking those as a literal statements, not sarcasm, and in that context I totally agree with you. On the one hand, we either have to agree that capitalism involves cutting off people when they leave the workforce, and leaving them to their own devices with all the associated costs of doing that, or we have to decide, as a matter of public policy, to pay for an ever expanding elder population.

By definition that has to involve rationing, whether achieved through profit driven insurers, or the federal govt. I realize this is the point of departure, as I believe the negative consequences (i.e. 50 million uninsured) vastly outweigh any economic benefit to the insurance market, and I certainly don't buy (what I perceive as) the fantasy that somehow, if we just let those nice insurers compete across state lines, that they'll stop price fixing. I just don't buy it; the health insurance "industry" is nothing but an economic parasite, in this capitalist's view.

To point six, my view as a liberal capitalist is that accumulating capital as a form of self insurance and to establish market power, makes sense. But I think we agree capital should ideally be applied. I am all for creating tax incentives to encourage that, particularly incentives to return capital to the US without onerous burden. That is something liberals tend to be very confused about.

I find it interesting, though, that you have a problem with someone, whoever they may be, who becomes president of the United States, then becoming wealthy. Our system rewards both fame and infamy. That's just a natural function of capitalism, I thought. I expect we agree there are pernicious effects surrounding the intersection of money and politics, but President Obama getting rich (and I think your estimate may be a little over flattering to his income), falls squarely into that "rounding error" you mentioned.

I think of myself as a "liberal capitalist," which I know is not in vogue around here. I'm all for rewarding hard work, and even raw intellect well applied. I'm not with the fringe lefties at all, actually. But I genuinely believe that socialized medicine is a matter of fairness; smart people enjoy enough of an advantage to begin with.

Your point about the middle class is, of course, spot on. We often talk about the "loss of the middle class," but the reality is that the middle class has simply moved downward. Indeed, every single class but for those of us in the top 20% of the income distribution have had their standard of living reduced in the last twenty years, and even that number will continue to shrink.

I think my main point is that capitalism is just another system - granted it may be the most productive one in history, but it isn't exactly gravity. Why don't we privatize the military and police? Look at the effects of privatizing prisons.

Do you think the free market that led to "Robber Barons," vast income disparity, and eventual economic collapse of the Depression was better? Which liberal policies are driving income disparity today leading to the next pending collapse? Is there a reasoned limit to the reduction in marginal rates, or would things magically work better if we just didn't collect taxes at all and dissolved the government entirely so as to not impinge on the free flow and application of capital.

Like you said, the healthcare debate is extremely complicated; as attractive a panacea as the "invisible hand" appears, I don't buy it when it comes to healthcare.

I'd also like to thank you for your civility. Not many folks here are capable of it, and it is so refreshing. I especially agree with your point about the irony of poor having to pay the full full price in order to subsidize the rest of us.

I would like to ask, though, about your view of the relationship between the three fold decrease in elder poverty between 1965 and 1980, and medicare. Perhaps that is economically inefficient because it prolongs unproductive lives? My understanding of the results of medicare is that younger workers no longer have to live in poverty themselves in an effort to support their sick parents. While no system is perfect, it does seem on balance that is a good thing.

My own belief is that GOP faithful see elder poverty as a desirable effect, because it reduces competition for resources (i.e. access to care), while simultaneously reinforcing the generational economic immobility of the poor, hence reducing competition for the wealthy. It's sort of a win-win, for rich people.

After all, one of the chief complaints I hear from the GOP about the ACA, is that it will unfairly restrict their access to the "best care in the world" because, you know, all those poor people who were being left out to rot, aren't any more. Personally, I see that as a morally bankrupt position.

@Mac Moore there is a health care agency that also fixes prices for services and medications and actually bargains with the drug companies...it is called the Veteran's Administration. And it is the only current agency allowed to do that with some exceptions for standards of care dictated under Medicare. People argued that the basis for standards of care should be universal Medicare...but perhaps it should be universal VA care. People of means will always seek out the care they want at whatever price they are willing to pay. That part is not going to go away from our medical systems. And logic would seem to support the idea that if the insurance companies wanted to make real returns on the premiums they get, they would encourage all their patients to be as healthy as they can be. If everyone has to pay something for care, then the emphasis should be on getting everyone as healthy as possible as a base model and dealing with the catastrophic situations asbest they can including research and new drugs or other modalities of treatment. What good does it do to pay for 14 drugs to support a person who is obese, diabetic and in heart failure in the end game if they have not been encouraged to not arrive at that horrible health destination to begin with? Somewhere along the course of time those supposedly healthy younger people are starting down that path to those diagnoses and if the ones I see on the street are real members of that age group it will not be long!

Nifty idea, David. Trouble is, the President keeps handing out exemptions to this Most Magnificent Legislation Ever to scores of politically connected cronies begging not to be assaulted with His eponymous law, as well as delaying and deferring key parts of its wonderfulness.... It's kind of hard to market test this sumbish.

David offers, " But the reason Repubs are so apoplectic is they fear that people will actually like it"

That makes no sense at all. By the same logic, then, the Idiologues of the Left forced Obamacare through, without compromise, debate and with Federal Funds for bribery because they knew nobody would vote for it otherwise. Heck, the only bipartisan effort on Obamacare was in its opposition!

So, the Ideologues on the Left inflicted Obamacare on America and walked on the GOP to do it. Now, they want the GOP to pay for it too? As the old saying goes, be nice to the people on your way up ....! But, we really can't expect far left ideologues to understand that, can we? Pay back can be such a bear!

David- Your comment makes no sense. You suggest if we believe in our principles we should allow something to bankrupt the country before doing anything about it. No, it is precisely because we believe in our principles that we must act. Rove, misses a significant point which is that republicans didn't vote to shut down the government or to not pay the bills. In fact they voted to pay the bills while not paying for Obamacare. Now the democrats in the Senate have to vote to shut down the government or agree to deal with Obamacare as a separate issue from the rest of the country's bills. The democrats of course don't like that idea because they don't want to be forced this close to the campaign season to go on record as supporting a ACA which the majority of Americans don't want.

David, the ACA is a simple plan for reducing the value of medical care. Yes, care for the indigent and working poor will be available, kinda. In the long run, ACA will create enormous public debt problems, AND the quality of medical care available will stop dead in its tracks. Not to say that isn't all that bad an idea. Just that the public seems oblivious of the fact. There won't be much care for cancer, or for heart attacks for that matter. No one will lose medical care coverage, but the value of that coverage will drop over time. The United States medical care industry has in fact been the primary driver of medical advances in diagnosis and treatment for the past 60 years. Let's hope someone, somewhere will pick up the ball....

I simply disagree with your description of the differences btwn conservative & liberal mindsets. Moreoever, I believe that the liberal mindset has been displaced by the progressive, and that few folks have a clue about the difference-that includes liberals. I do not believe that the differences in attitudes about the free market economy are at issue. Progressives have taken on a moralistic viewpoint that approximates a religious conviction: That government can produce a perfect society and thereby a perfect human being. Their hatred of religion, of human pain & suffering, of human nature, of traditions, of a planet & universe that treats us as trivial, etc all warp the picture. Progressives have taken the idea of individuality as supreme, to a god-head....it just won't work.

Humans must live in community. The individual is not more important than the community. I think we are simply debating what constitutes that community. and then how far can any formulation of govt extend itself into the community/-ties? I guess at 68 I find the atomization of community in Facebook and Twitter absolutely tragic. Strange though, how the youngsters suffer the same problems even though there is so much less physical contact. But I know it severely reduces contact with the older generations, which is the true source of learning. I read recently in a scientific rag that Neanderthals were never able to develop a culture capable of growing because childhood was so short. A mere 5 years from birth to procreation. The long childhood of humans in contact with adult community has been the driver of our religions, our cultures and our knowledge of the world around us. Most of all it has allowed humans to face risk and exploration.

Your second ¶ concerns me. Why are local dollars = local power "tripe?" I would tend to say that local control is autocracy. I am one who suffered terribly under local social constraints in HS. Hence I supremely value our Constitutional right to move anywhere within the nation, and move I have. Local control Constitutionally is absolute, that is the Bill of Rights was added to provide avenues of redress to the federal govt for individuals. Still didn't help the slaves. So we have the 14th Amendment. But I would ask you, now that all the power resides with the feds, to whom would you apply for redress from abuse of power?

Regarding the printing of money, The value of the dollar was separated from the value of gold and silver not that long ago. Until that time, our fed government really could not simply print money. When they did, and they did, there were terrible uproars. Also, until the income tax was instituted in 1913, the federal government was very constrained by limit funds. Some of our FFs did predict the problems we are having should the federal govt ever find a way to bypass financial constraints.

Erich, the $$ I said will become Obama's when he leaves office, are campaign donations that were not used for campaign activities, not income earned. Obama received $1,072,600,000 in campaign donations in 2012. I was wrong to say that he will have a billion; he will have only a million. He spent 985million. Do you have no problems with politicians filling their wallets via political activities. Sounds like the gangs & racketeers. Again, who would a person who has been inappropriately strong-armed go for redress?

In a free market, the buyers are supposed to be free to purchase or not purchase. Those who offer the goods and services at a price that can clear the market, will thrive. Those who offer goods that do not suffice will not. Of course, there are wide variations in the types of problems and abuses that can occur. But do not confuse free choice for market transaction with political markets. In concept & practice, they are very different indeed. Kinda like the debate over guns... One you can walk away from, the other demands some specified action by you.

The following quote summarizes what I believe was the crux of our Founding Fathers' goals when establishing the Constitution:

"A core value of civil society is a respect for beliefs and norms that differ from our own, and the forebearance from using political means to enforce norms that do not attract broad public consensus." Kevin D. Willliamson

I had started a reply that was deleted by an flying keystroke. I will outline the key components that I consider critical to the solutions you seek.1. Politics is soley the use of a given power to address a problem. Our system of govt does not make for efficient use of federal power to solve local problems.2. Our geog. size and economy approx the same as all of Europe's, but their 'socialized medical systems are national only. Many complain about immigrants coming in to get medical care.3. The above suggests to me that the problems to medical care payments systems are based in human nature.4. Social Security was a grand success because the worker considered their FICA payments a type of savings program, despite the fact that most of the original 'contributors paid in a fraction of what they received back. Resch the effect of inflation and the literal inability of a government to save/invest.5. Medicare similar to #4 with the increase of the FICA tax to 15.3%6. Big government requires big business. T. Roosevelt knew what he was doing by instituting the Anti-monopoly laws. Today, we want big national businesses but we don't want them to accumulate money. In Ad Org in the MBA program, we learned that executive salaries are usually a rounding error in the financial reports. sooo, the bigger the corp income the bigger the exec salary. As a donor, I am now seeing the same problem with successful NPO's and am increasingly distressed. But Fed's are not inclined to break-up the super deep corps. Where in heavens name do you think Pres. Obama got his billion$ campaign chest. Like BofA, where would they be able to threaten dissolution simply to tap the monies deposited and save by ordinary citizens. The money they are taking from BofA is criminal.[by the way, do you know that politicians get to take campaign $$ not spent on campaigning, into personal account when they retire from politics? Mr. Obama went from Neighborhood Organizer (in a neighborhood we lived in 1982-84), to retired billionaire in less than 10 years w/o adding any economic advantage to our nation]

Erich, I too would love to hear a reasonable debate with real data and with simple, non-political goals regarding medical care & expenses. As a political conservative and social liberal, I might sound a bit schitzo occasionally, but it does work. The problem today is so complex, that many people say the only solution IS socialized medicine. But that is nothing more than rationing, without regard to cost-effectiveness or social needs or anything other than limiting to total amount of $$ spent in the medical econ sector. Believe the rich will get what ever they want. The key to any economy is the middle class. Read history. The rich and the poor have always been in every human community bigger than a tribe. But, the middle class is really special. Quit trying to take money from the rich to build a middle class. The middle class merely needed/needs to be enabled to build an economy. Pres Obama hasn't a clue, and Mr. Reid, I cannot figure for the life of me. Speaker Boehner is really a very astute politician in the best use of the word/

RA N - please support your assertion regarding medicare being unnecessary. As I mentioned in my reply to Carolyn, there seems to be a strong correlation between the "socialized medicine" offered by Medicare and the reduction of elder poverty.

Do you mean it was unnecessary because it artificially extended unproductive lives?

Very right, Tom. And to both RA and Carolyn, there IS NO FREE MARKET for Medicakl insurance. The giant HMO's have divided the country into regions and 8-12 companies now own almost 90% of all claims. The ACA is going to work with those companies, but has already begun to impose cost controls and ways to regulate and oversee what they are doing. We have a de facto monopoly here in the US, it's the main reason our costs are wo much higher than other developed countries, and most of those revenues go to pay for markketing and to salaries in the executive suites.

My story occurred at a time when the system actually worked. I see no horror in any of it. The system wasn't dominated by money. There was patience and accommodation. The neurosugeon only represents what all physicians now do--tell their CPA how much $ they need per year and how many hrs they want to work. The charges are then calc without the MD ever really knowing what they are.

ACA confuses the practice & economics of medicine even further, because the basics of medical education and practice have been over-financed. So how can we change the education and practice relationships and get costs under control, at least for socialized care or a true insurance-type payment system? (--actually both are needed for a humane, economic medical system. Those who pay serve to price the market, so that the community can afford to pay for those who cannot)?

One additional problem, that must be addressed, is the expectations of the people of this country that they shall receive professional attention for the smallest bubu and not have to pay for it. Are these expectations containable, reversible?

Wages for many workers have not increased directly over the past 20 years, but look at the expansion of their medical, dental & health insurance--that is where the wage increases went, and the worker/s found it worthwhile to take FULL use of the expanded coverage. Problem is now they want $$ for other things in addition. and the $$ simply aren't there. and in the meantime the professionals have also gotten used to the increased incomes and limited hours. You reduce the $$ going to the professionals, they are highly educated, they have alternative places to find incomes; they will leave medical practice. That's the 1st event of ACA reducing patient access & timeliness.

We need a policy-study group of persons who know much but are not necessarily dependent on the current system. Areas ripe for redesign now include the economics demand for care, economics and the humaneness of medical education & practice. Our current medical costs are out of affordable domain for even socialized medicine because we now have an inverted pyramid, with specialists at the base with longest training time & top incomes, and family physicians at the bottom. Should be somehow re-inverted.......continued if you are interested

Our Congress was basically majority Democrats after the war and throughout the post-war expansion, as we became the most powerful nation in the west. The Unions were basically an advisory board. Note also, that USA manufacturing giants had no competition, and profits esp. as the rest of the world began to recover were enormous. (This is all the opposite of the current world economy.) The Demo Congress and the Unions saw the one way to distribute the profits to the workers was to enable employer paid 1st$ medical care "insurance." Fast forward 50 years of free medicine for the middle class and up. 1st dollar 'insurance' holds no one accountable for the quality of care. The medical care system became like the churches of the Dark & Middle ages -- all of the 'profits' of the economy are going into cathedrals of medicine. "medical advances" have produced some really exciting breakthroughs in survivals, esp for children. And these breakthroughs have helped people all around the world. We have learned so much about illness and health and genetics and... But, the price tag is - well, I haven't the guts to look it up. You look it up.

All I can say is that the majority of the folks with high income you want to tax to pay for "medical insurance" are physicians, most of whom are specialists. (The number of corps with hi paid exec is too small to account for the # in upper 1%) Therefore, ACA is merely taking our tax monies and distributing them to the wealthiest group. Tax them all you want. Whatever you do, you won't make medical care available at a lower cost, without 1) reducing the number of physicians (at lower income), & 2) increasing the difficulty of seeing a doctor when you need one, and 3) making all those wonderful new cures unaffordable. The old "Free Clinics" of the past may re-emerge, and many in the middle class will probably be in the waiting room. The economics of this fact is that in the 70's med students graduated with approx 80-100K of debt for tuition. Today med students are entering with that or more in college debt. Medical schools are now as more expensive as colleges are.

I will return later with my proposal to rein in medical care costs and maybe keep close to the current level of medical care quality--which by the way has been on the downward spiral for some time, except for the those medical problems that cost the most.

Tom, The solution is simple - use the free market. We haven't had a free market in healtcare since 1965. Once Medicare and Medicaid were instituted (unnecessarily, by the way), cost shifting to privately insured began. In the '60's there were only a handful of state and federal health insurance mandates. Now there are tens of thousands of them. Each one drives the cost of insurance up. Frivolous malpractice lawsuits, fanned by trial lawyers (huge Democrat donors), have caused insurance rates to sky rocket. The feds not allowing insurance to be purchased across state lines. The FDA over-regulating and delaying approval of life saving drugs and procedures. Do you see where all this points to? Yes, government is the problem. Politicians like Obama, Pelosi and Reid saying they have the solution is like an arsonist running to the fire he set with a bucket of gasoline saying he can put the fire out. Obamacare does nothing to make "care" more "affordable". As with all big government programs, The Affordable Care Act is named in Orwellian fashion. Kinda of like the Peoples Democratic Republic of Korea.

Get gov't out of the way. Get the bureaucrats' jack-boot off the neck of the American people! Now, do you understand the problem and the solution, Mr. Independent?

Ed - I think Donald makes a fair point, if I don't really find the rhetorical content that strong.

If only from a tactical perspective, making reasoned exceptions during a complex implementation is only giving the other side ammunition, as we see here.

The reality is that the ACA is, in fact, a horrible law. It's horrible because its first principal is to do no harm to the insurance industry and to not interfere with the exceptional inefficiency of a) building the price of healthcare into every widget we (use to manufacture), and b) allowing the financial industry to effectively extort income from workers in the form of useless coverage which will still bankrupt them if they have the misfortune of being sick or injured.

Instead, it places unfair burdens on small businesses, further reduces the competitiveness of the United States, and, don't forget, continues to funnel capital out of what I affectionately refer to as "the real economy," into the "financial casino" some of us are getting pretty rich in.

Until we wake up and create a healthcare system with parity to the rest of the industrialized world, we will continue to lose our competitive advantage and the, apparently, inexorable decline into a third world nation will continue unabated.

But don't worry - those of us with wealth will just leave, so that'll be ok, I guess.

That's just an exaggeration of the facts. You oughta be ashamed. The Business Mandate affected a tiny fraction of businesses, likewise the Government employee exemption. You don't like the exemptions? FINE. Tell your Congressman to draft legislation and get rid of them. But that's not really your point, is it.

I'm remembering some historical ramblings about a "permanent Republican majority," and some rather explicit exclusion of the minority the last time the GOP bamboozled the country only to be routed when the lights came on. But don't worry - I'm sure that won't happen when y'all default on our debt.

So, do please feel free to be part of our democracy if you like. But the GOP isn't "paying for it," the taxpayers are. You know - the voters who elected the congress and the president. Those folks.

We had over a year of "debate", a special bipartisan committee, and over 400 GOP/Conservative ideas are part of the bill's compromises. Then the GOP voted en masse against their own amendments. David is right.

The GOP shuts down the Govenrment and causes a stock sell-off, they are going to pay big-time.

More to your point, Mac: The very House and Senate Democrats who forced this on us, along with Big Labor and scores of other powerful cronies of this administration, cannot run fast enough to get out of the way of this disaster. The thousands of hitherto supportive feet running away from Obamcare are testimony enough to the fact that it must be defunded and rendered null & void.

Of course it makes sense. The prospect that such a plan might succeed is anathema to a party whose whole philosophy is built around doing just the opposite, of taking from the “takers” and giving to the “job creators,” known to the rest of us as the “rich.” Hence the brinkmanship. Payback? Like I said, once people start to realize the common sense benefits, which I outlined in my original post, they're going to embrace it and then wonder why the GOP tried to burn the house down to deny them what every industrialized -- civilized -- country provides its own people.

Yes - the GOP is voting to shut down the government unless the majority submits to the blackmail. Sorry about that, but it's just plain as day, and while we all got to enjoy the delusions of the GOP thinking that a fabulously wealthy patrician was just cake walking to victory, this really is a lot more serious.

To be really clear about it - we did deal with the ACA as its own issue. It's called passing a law. That's what happened. Now, much like the GOP doesn't want to pay our bills, they think they needn't fund the laws of the land. Very principled of you.

But, I know, you're really angry about it so that makes it ok, or something. I think I'll throw a tantrum and take my ball home too, but at least I won't drive the country into another brutal recession while I'm at it.

Kyle, i make perfect sense. The ACA was enacted by Congress and validated by the Supreme Court. It is the law of the land, whether you like it or not. We are a nation of laws. Congressmen swear an oath to faithfully execute the laws. If the GOP doesn't like Obamacare, then it's pretty simple. Win a veto-proof majority in the Senate in 2014, win the presidency in 2016, and then introduce a bill to overturn the health care law. A responsible political party would work withe Democrats to improve it. After all, many of features embedded in the law were proposed by the Heritage Foundation years earlier. The GOP knew that Obama was not going to negotiate over a significant legislative achievement, and by trying to defund they're pursuing a reckless, irresponsible strategy that will sabotage this nation's credit and its economy. What the Tea Party is doing is economic treason. As for its cost, see my response to Carolyn Lawson. Obamacare has been enacted already in Massachusetts in the form of RomneyCare. It's working fine. And the American people haven't rejected Obamacare, they just don't understand it and unfortunately are being lied to by the likes of Hannity, Rush, et all, who cry "death panels." Think of it. The Republicans are willing to sabotage the economy over denying millions of health insurance on the same day they cut funding for food stamps. What an ugly political party.

Mac, prices are fixed and care is rationed by insurance companies under the current system. Insurance companies will still play a central role under Obamacare; they just won't able anymore to exploit loopholes in the fine print of your plan to deny you coverage.

David, "Carolyn, thanks for the civilized reply. I'm not sure why you're convinced that the ACA will reduce the value and quality of medical care"

Obamacare artificailly fixes prices. Price fixing has never worked. If a good or service is worth more than the fixed price, the good or service will either go away or dimenish in value. This is simple stuff. Obamacare is a Central Planning system that eliminates the Free Market method of price adjustments. Carolyn nailed it.

Carolyn, thanks for the civilized reply. I'm not sure why you're convinced that the ACA will reduce the value and quality of medical care. Do you have a study or data that you can cite to back up your claim? The ACA is based on three simple ideas. First, all Americans should have access to affordable insurance, even if they have pre-existing medical problems. Second, people should be induced or required to buy insurance even if they’re currently healthy, so that the risk pool remains reasonably favorable. Third, to prevent the insurance “mandate” from being too onerous, there should be subsidies to hold premiums down as a share of income. Is such a system workable? RomneyCare, a system similar to the ACA, has been operating in Massachusetts since 2006. No trains have been wrecked so far. The question is whether the Massachusetts success story can be replicated in other states, especially big states like California and New York with large numbers of uninsured residents. To the surprise of only Republicans, insurers came in with bids running significantly below expectations in California; in New York, it appears that premiums will be cut roughly in half. Over all, then, health reform will help millions of Americans who were previously either too sick or too poor to get the coverage they needed, and also offer a great deal of reassurance to millions more who currently have insurance but fear losing it; it will provide these benefits at the expense of a much smaller number of other Americans, mostly the very well off. It is, if you like, a plan to comfort the afflicted while (slightly) afflicting the comfortable. There's no reason to think, under this scenario, that quality will suffer.

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